Healthcare Provider Details

I. General information

NPI: 1720186521
Provider Name (Legal Business Name): GILBERT KEITH HILL II CRT, RPSGT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

11701 SW 3RD TER
MICANOPY FL
32667-5383
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT10909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: